Are you an Overseas Doctor working in UK or currently in UK, but unemployed?

If yes, this could be the most important mail you have ever received.

Please read this mail in full - Very important information enclosed.

What is happening?

From April 2006, two things, which affect you, are going to happen:

1. Permit free training for overseas doctors is ending. 2. Equal Opportunities policy will no longer apply for doctor's job selection. This means that Trusts will employ UK/EU doctors in preference to overseas graduates irrespective of qualifications and irrespective of visa status.

Trusts have already started recruitment with the new policy with the explicit statement: " UK/EU candidates will be given preference over non-EU overseas graduates" (eg: http://www.jpaget.co.uk/med_rec/Medicalvacancies.php)

Why is this a problem?

This was announced without any Consultation or grace period. This has significant implications for overseas doctors at all levels of training. They will find that after years of serving the NHS, they are being thrown aside in job selection. There is no guarantee that they will continue to be employed in further posts. Many will have to relocate at short notice, causing disruption to career, finances and family life, not to mention training. This is shocking news to all of us who came here believing in the promise of Equal Opportunities.

What are the implications?

All Doctors: You will have to change your Visa status. There will be NO Equal Opportunities in job selection and your skills and qualifications will not matter.

Those on HSMP, Permanent Residency etc will also be considered as "overseas doctors" for the purpose of job selection and will be considered only after UK/EU candidates.

SHO: You may never complete your "training". For those who want only MRCP and not UK jobs, remember that most Royal Colleges want 2 years "approved training posts". If you don't get a job, your Work Permit will end and you will become an illegal resident from the next day. If you are currently unemployed, you will almost surely never get a job / "training".

Registrars: You will require a separate work permit for each job in your rotation! And for those planning to specialise further, the door is shut firmly on your face. And you will never become a Consultant! (What you do after your SPR training is anybody's guess… Think of all the time you spent on learning "Consultant skills!) Isn't it gratifying to note that an EU candidate with no " UK experience " will be automatically considered over you for Consultant job selection, without regard for skills or experience?

What can we do?

The Time to Act is NOW.

Don't postpone it to tomorrow or expect others to fight your battles. Overseas doctors associations including British Association of Physicians of Indian Origin (BAPIO)are already gearing up to protest this unjust rule.

? FORWARD this email to all overseas doctors in your address book NOW. Sadly many are still not aware of the dark future ahead.

? KNOW more about this issue by visiting http://imgprotest.moonfruit.com/, a web site designed to promote the protest movement and containing updated information.

? SIGN the online petition at this web site which is being submitted to the Secretary of State for Health

? PARTICIPATE in the peaceful protest march to be held in London in April , being co-ordinated by Dr Satheesh Mathew, Consultant Paediatrician from London.(Date to be announced shortly, hundreds already committed)

? DISCUSS these issues with your colleagues and ask them to sign the petition as well.

? PARTICIPATE in the BMA Junior Doctors Conference at London and vote on the motions thereby deciding policy.. You don't have to be a BMA member. You will be reimbursed travel and hotel expenses by BMA . This is a golden chance to make your voice heard. Visit this link and REGISTER NOW. Registration is closing soon

http://www.bma.org.uk/ap.nsf/Content/juniorsconference

? BAPIO is also circulating a paper petition, which I am attaching to this mail. Download it, fill it at post it back to the address given.

Proposed protest in response to the changes
Letter from Dr Satheesh Mathew:****Dear friends,

You have heard from Dr. Ramesh Mehta that we are planning on apeaceful demonstration in front of Department of Health. Sooner thebetter. I have been entrusted with the responsibility of organisingthis demonstration on behalf of BAPIO. We are also planning onsigning petitions to be submitted to the Health Secretary.

I do not know of any other medical organisation, which has organisedsuch a demonstration at least within the last twenty-five years. Wewill be holding a preliminary meeting in my hospital with a handfulof members next week. The week after we will hold a bigger meetingin Eastham. If any one knows of a venue, which will hold, about 100people please let me know. Then depending upon the response we willhold the demonstration in front of Department of health as soon asis practicable.

I keep on saying that there are about 5000 post plab unemployeddoctors in this country. If there are 5000 PPUD's then we shouldhave at least 5000 doctors for our demonstration in Central London.We cannot expect others to fight for us. We have to takeresponsibility and fight for our cause. I also hope many otherdoctors currently in training and more senior people to join us.

About Seniors =96 many of them are already British citizens, many oftheir children are already local graduates and there others who arein Medical schools. This new rule if they look at it with selfishintend is good for them in the short term but not in the longterm. I hope that many of the seniors will also be able to join usfor the demonstration.

Published: 7 March 2006By: Dept of health, Sally AldousAll international doctors now required to have a work permit to work in the UKAll doctors wishing to work in the UK from outside the European Union(EU) will be required to have a work permit from July 2006 HealthMinister Lord Warner announced today.The move means that any NHS trust wishing to employ a doctor fromoutside the EU will have to prove that a 'home-grown' doctor cannotfill the vacant post, ending the current permit free trainingarrangement for international doctors.Health Minister Lord Warner said: "We now have more than 117,000doctors working in the NHS, 31,000 more than in 1997 as well as recordlevels of doctors in training in UK medical schools."This investment and expansion, coupled with the reform of medicaleducation, is leading to increased competition for medical posts asvacancy rates fall."Therefore, to ensure that we are only recruiting doctors to the UKwhere we have a genuine skills shortage NHS Trusts will be required toget a work permit for every doctor that they wish to employ fromoutside the EU."In future IMGs who wish to work or train in the NHS will need a workpermit. To obtain a work permit an employer must show that a genuinevacancy exists, which cannot be filled with a resident worker."We recognise that international doctors have made a huge contributionto the NHS since it was founded in 1948 and there will still beopportunities for overseas staff to come to the UK. We will continueto need small numbers of specialist doctors, who can bring theirskills and experience to the NHS. However, increasingly the NHS willbe less reliant on international medical recruitment."The changes will come into action shortly when the NHS will only beable to recruit internationally when they cannot fill a training postwith a UK graduate.The only exception will be to allow two years of permit-free trainingfor non-European Union nationals who have trained in a UK medicalschools so that they can acquire full registration with the GMC.Any doctor wishing to apply for postgraduate medical educationtraining in the UK , whether at the Modernising Medical Careersfoundation programme level or senior house officer stage, will berequired to have a work permit.Currently international medical graduates (IMGs) are able to undertakepostgraduate medical education in the UK without needing a workpermit.Health Minister Lord Warner added: "The Department of Health willcontinue to work with the General Medical Council to ensure that IMGswho are interested in working or training in the UK understand exactlywhat type of job and training opportunities exist. "--

New Visa Rules For Overseas Doctors
Dr Anustup Bannerjee forwarded this mail to the group:

It needs no explanation...

Changes to the Immigration Rules for PostgraduateDoctors andDentists

On 7 March 2006 the Department of Health announcedthat the HomeOffice would be making changes to the immigrationrules forPostgraduate Doctors and Dentists

The changes, which will come into effect on 3 April,aim to amend thecurrent specific category within the immigration ruleswhich relateto Postgraduate Doctors and Dentists. In future, theonly doctors anddentists who will be covered by the existing ("permitfree")arrangements are those who have completed theirmedical degree in theUK and have been appointed to a 2 year FoundationProgramme.

The Home Office has also announced its longer termpolicy on managingmigration, based on a points based system for peoplecoming to the UKto work, study and train. The Home Office aims tointroduce the newsystem in stages to replace the current arrangementsand simplify thesystem for employers and migrants.

What does this mean for future recruitment?

You need to ensure that any offers of appointment youmake are linewith the new rules. When you advertise your post,applicants arelikely to be British Citizens or fall into thefollowing categories;

• EEA nationals• Doctors and dentists with existing leave to remainunder thecurrent immigration rules for Postgraduate Doctors andDentists• Doctors and dentists who require a work permit• Doctors and dentists who have leave to remain underthe HighlySkilled Migrant Programme• Doctors and dentists who are in the UK by virtue ofanotherimmigration category e.g. those with leave as adependent – eachspecific case would need to be checked

EEA nationals have the automatic right to work in theUK and shouldtherefore be considered in the same way as UKapplicants for posts.

Doctors and dentists who have existing leave to remainas aPostgraduate Doctor or Dentist will be allowed to stayand train inthe UK until that leave expires. Therefore, if thepost on offer willbe completed within the period of thedoctor's/dentist's existingleave, the employer (and the doctor/dentist) will notneed to seekpermission from the Home Office for the doctor/dentistto take up thepost. However, from 3 April doctors and dentists willonly beeligible for leave as a Postgraduate Doctor or Dentistfor theirFoundation Programme, and then only if they havestudied in the UKand meet all the other requirements. If you haveoffered a post to adoctor or dentist who currently has leave as aPostgraduate Doctor orDentist, but their leave will expire before the end ofthe post, thenthey will need to apply for a different category ofleave to completethe post. It is likely that the work permit systemwould be the mostappropriate category - see the information on workpermits below.

The majority of candidates for posts will require awork permit. Thismeans that you need to apply to Work Permits (UK) fora work permitbefore you can employ the candidate. When you make anapplication fora Work Permit you will have to demonstrate to WorkPermits (UK) thatthere are no suitable EEA nationals who can take upthe post. Inpractice, this should involve very few adjustments toyourrecruitment processes. However, once your closing datehas passed,you will need to review how many applicants are EEAnationals and howmany would require a work permit. Depending on howmany posts you arefilling, and how many applicants fall into eachcategory, you willthen need to decide whether to assess the EEAcandidates first orwhether to assess all of the applicants at the sametime. Theimportant thing is that, before making any offers ofemployment, youmake sure that the suitable EEA nationals areconsidered in advanceof those who require a work permit.

If you are advertising a popular post, you may wish torestrictapplications to only those doctors who do not need awork permit totake up the contract. This should reduce the number ofapplicationsyou have to deal with.

Where a work permit is required, you, as the employer,need to applyfor a work permit on behalf of the doctor/dentist.When this isissued, the doctor/dentist themselves will then needto apply forleave to remain as a work permit holder. If thedoctor/dentistcurrently has leave under another category of theImmigration Rules(for example leave as a Postgraduate Doctor orDentist) then theywill not be able to take up the post until both thework permit hasbeen issued and the doctor/dentist themselves has beengranted leaveto remain as a work permit holder.

Not all doctors and dentists will be able to changethe basis oftheir stay (switch) within the UK. Those in the UK asa PostgraduateDoctor or Dentist can switch into leave as a workpermit holder, butthose with leave as a Visitor or as the dependant ofanother migrantcannot switch into leave as a work permit holder andwill need toleave the UK and make the appropriate application forentry clearancefrom abroad.

Some doctors and dentists may have been accepted ontothe HighlySkilled Migrant Programme (HSMP). Doctors and dentistswho have leaveunder HSMP can take up any training or employmentposts you offer,without the need for you or they to ask the HomeOffice forpermission

'A Job' in the UK
We have had a few e-mails from people in India asking about how long it takes to get a job, how hard it is, does it help to be a PG etc....

I post a mail from Dr Alaknanda, to similar effect, with replies from myself and Dr Amit Todani - the message being - clear your perspective about what 'a job' means, and do not set an upper cap to how much you might be expected to spend - because we can't!

Please note: these are our observations - u are the master of your own folly :)

Mail 1: From Dr.Alaknandai just checkd the plab forum and found out that an aspiring plabber must be prepared to spend an additional ~Rs4,00,000 besides the ielts and plab fees for the long period of unemployment that comes as a package with passing the plab test-theres also a 25%better chance of getting a job if the candidate has a PG degree-id really like2 know if its true-i personally know someone whos an orthopod and had a tough time finding a job there and that was 4yrs back is the condition equally pathetic for USMLE aspirants?i know the expenses for the usmle steps 1,2,2cs&3 but id be grateful if i cud get some information about the additional expenditures(that is not available in the ecfmg website)-i just want to have an estimate of the expenses before i embark on anything-and is it required to appear for an exam like ielts for usmle as well?and r the prospects of finding a job in the us as bleak as in the uk?

Reply No 1: Me being the devil's advocate [sort of]

For Alaknanda and others thinking bout UK,

For everyone aspiring to come to uk, I would like to point out a common mistake we make during our research - we focus on 'a job' . it's always 'a job' , even GMC gives it's evidence as time taken to get 'a job'

In reality, 'a job' could be in a subject u have no interest in. It could be a prho [intern] job even though u may be a PG, it could be a honorary job - where u get no pay at all, or a locum for a single day [at rates of 14-18 pounds an hour before taxes] , several friends, including nrsites have been doing intermittent locms that gives them just enough to manage a week at a time, with occassional aid from family and friends. Others have been able to get jobs at gp surgeries collecting data etc [for which you would first need a work permit or dependant visa].

On an average the waiting period to get a job that at least helps u survive the month - is a year . no evidence available, this is ust my subjective experience. in this year , you would be applying for your visa 1 - 3 times [i think bout 400 quids each time? ] you would be living in some accomodation - 50 a week you would be tragvelling, calling people, making a million coies of your cv and then using royal mail to send out parcels the size of your average 'desh' or 'sananda' - [15 copies of your cv if you don't mind]

If you were living in London, a day's travel could cost you from 3.50 to 7 pounds .O and now it is necessary in some jobs to have a valid uk license - the international license is no longer valid. its bout 70 pounds for the two exams, 5 pounds to send your passport to apply for the license, and 20 pounds per lesson - yet to meet someone who did not take at least 10 lessons and passed. - yet to meet someone who passed att he first instance. some jobs insist u have your own car. and i know one unfortunate indain , who lied about it, and although he wassuccesful at the interview, lost the job later when he said he was willing to hire a taxi for every trip he had to make.

I could go on about the list of expenses involved. This is not to scare you, but to give u a better picture of what you are going to face.

Bout PG degrees, i have no clue. I really dont know if it's any easier to get a start, but career progression might be quicker. worst comes to worse, at least you know you can do stuff if u had to return ..

hope that makes some sense.

RegardsSunanda

Answer No 2: From Dr Todani, who is more actively in the job hunting scene:

I agree with sunando. there is no doubt in the authenticity in any of his statements, only he has been a bit `moderate'. The picture is actually a bit worse (actually a lot). may i add that if you really want to be in a decent position to 'apply' for a particular speciality, u need to have completed all the courses IN UK relevant to that job, eg ALS/ATLS for A&E/surgery/medicine (GBP 450 +), microsurgigal skills course for ophthalmology (GBP 500 +) plus parts 1 & 2 of membership examinations (300-400 Quids each). Regarding PG, if you are unfortunate enough to have done a PG back home (except MD in anaesthesia or DA), U would end up sitting on the fence. It would not only restrict your choice of specialities (imagine an ophthalmologist applying for a Gynae job!), but also exclude u from Foundation programmes (yes even most standalone F2s). If u noticed the recent ad for the run-thru grades, those having more than a year's experince at SHO level are automatically filtered out from ST1 pilots. Even the GP jobs would be restricted to those who have completed Foundation Programme in UK from Aug 2007. Regarding locums, u can't do any locums on PLAB visa and u dont get a PFT or work-permit for any locum less than 3 months (and u need to get a Dean's Letter as well stating that your locum is a recognised training post). Each time u go to get a visa stamp, it costs u GBP 500. At the end of it, if u end u getting a substantive job within 1 year, u would be one of the priviledged few as there are thousands of doctors who have either done a few locums or are completely unemployed even after one and a half years. As with everything, there are exceptions. I personally know a girl, who got 3-year GPVTS within 2 months of coming to UK even without doing a Clinical attachment and no experience whatsoever at SHO level.Hope that helps!

Little caution....
'parthasd' recently contributed to the egroup with this mail. it paints a grim but realistic picture of our future in the UK.I usually try not to discourage people, but recently I have had to listen to people who came here with an unrealistic expectation of the future, and now several thousand pounds down the line they can only say that people are getting jobs because they have 'catch'. They scoff at simple suggestions to try their best by saying things like, 'from your position it must be nice to give such advice, but the reality is quite different ....'

Bottom line, don't come here expecting sympathy. You come here to struggle and u shall have to fight till the last penny.

Enough ranting, here's parthasd's view:

I am completely new to this group. I am in the UK for last 7-8years. Don't quite know about the recent changes in the PLAB test.But one thing is certain, things are definitely getting more andmore difficult. And of course there are exceptions.

MMC (modernising medical curriculum) has changed the whole equationin the last 2-3 years. The situation is going to worsen further inthe next two years. Currently it is extremely difficult to get atraining SHO job. [My last SHO (London graduate, white AND a lady)could not find a job from August and headed south (Australia).] Sameis going to be the case with Type 1 SpR (higher specialty training)jobs in two years time once the current foundation trainees will beready for the 'seamless' higher specialty training. What they willbe able to do after becoming a 'junior' consultant is everybody'sguess.

Anyway, the Royal College of Surgeons of Edinburgh took the bold (!)step last week to warn all overseas candidates about planning foran 'exit strategy' or to take up non-training career grade post forthe rest of their lives. They predict that there will be about 500training numbers nationwide for general surgery and 1,500 UKqualified candidate alone aspiring for a career in general surgery.Therefore, only 1 in 3 UK graduate aspiring a surgical career willactually make it through. Although the RCS 'warns' foreigngraduates, I suspect, the much hyped 'equal opportunity' will betactically thrown out of the window.

UK is not going to be the ideal place to invest your time and moneyunless you are not already in the system (by that I mean, you arehere in a training post and having done with all the 'M' exams/research/ publications etc).

Surgical specialties have traditionally been more difficult thanmedical specialties. This is going to be the case for the forseeablefuture.

Sorry to give a gloomy picture but unfortunately this is the realsituation. Hope this helps.

Question bank for interviews?
I have collected a set of questions that are asked at Psychiaitry SHO post interviews. Drop a line if any one is interested.

For those who have already faced interviews:I would appreciate getting more questions , not only for psy, but for other jobs as well. Admit it, answering questions about your weaknesses was not something you were comfortable bout right from the start???